Five Shovel-Ready Health Care Reforms

BRIAN KLEPPER and DAVID C. KIBBE

Microsoft Health Vault's leader Peter Neupert has a wonderful blog post that makes two important points really well. One message is that health care reform is about the outcomes, not the technology. We should think expansively about which technologies to invest in, based on the results we want to get.

The other message is the economic stimulus package is different than the reform effort. It is moving at hyper-speed through Congress, and it may be difficult for staffers and other advisors to sort through and incorporate what may seem like opposing Health IT views against a backdrop of traditional ideology and extremely forceful special interest lobbying.

Welcome to Health Wonk Review (HWR), 1/09/09

Brian Klepper

First Published on THCB

Well, here we are at the beginning of 2009. On TV we’ve learned that the unlimited spending and brilliant, if socially pathological, heroics of Dr. Gregory House, unfailingly saves his patients from unknowable complexity and the abyss of death.

Meanwhile, the rest of health care, aided largely by really excellent lobbying, continues to be buoyed, defying the relentlessly corrosive gravitational pull of waste, corruption, and a tanking economy.

Still, health care's troops are beginning to feel, in Tom Lehrer's words, like a Christian Scientist with an appendicitis. Things definitely are not going well, and this longstanding run of great good fortune could be on the downswing. Is it possible that exorbitant pricing and massive waste are NOT entitlements!

Let's Reboot America's Health IT Conversation (2): Beyond EHRs

DAVID C. KIBBE and BRIAN KLEPPER

First Published on THCB

Yesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're only one of many important health IT functions. EHRs and health IT alone won't fix health care. So developing a comprehensive but effective national health IT plan is a huge undertaking that requires broad, non-ideological thinking.

As we've learned so painfully elsewhere in the economy, the danger we face now in developing health care solutions is throwing good money after bad. We don't merely need a readjustment of how health IT dollars are spent. We need to reboot the entire conversation about how health IT relates to health, health care, and health care reform. To get there, we need to take a deep breath and start from well-established and agreed-upon principles.Most of us want a health system that, whenever possible, bases care on knowledge of what does and doesn't work - i.e., evidence. We want care that is coordinated, not fragmented, across the continuum of settings, visits and events. And we want care that is personal, affordable and increasingly convenient.

Let's Reboot America's HIT Conversation 1: Putting EHRs in Context

DAVID C. KIBBE and BRIAN KLEPPER

First Published on THCB

On Dec. 19, we published an Open Letter to the Obama Health Team, cautioning the incoming Administration against limiting its Health Information Technology (IT) investments to Electronic Health Records (EHRs). Instead, we recommended that their health IT plan be rethought to favor a large array of innovative applications that can be easily adopted to result in more effective, less expensive care.

Medscape Video: Re-Empowering Primary Care

An Open Letter To The Obama Health Team

DAVID C. KIBBE and BRIAN KLEPPER

First Published in THCB

It seems likely that the Obama administration and Congress will spend a significant amount on health IT by attaching it as a first-order priority to the fiscal stimulus package. We take the President-elect at his word when he recently said:
“...we must also ensure that our hospitals are connected to each other through the Internet. That is why the economic recovery plan I’m proposing will help modernize our health care system – and that won’t just save jobs, it will save lives. We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.” (December, 6, 2008)

Re-Empowering Primary care

Brian Klepper

A video-commentary that appeared - see here - on the Medscape Journal of Medicine.

Over the last couple decades, America's primary care physicians -- PCPs -- have been relegated to medicine's lowest caste.^[1] But many employers, who pay for the waste that results from tying PCP's hands, now see them as healthcare's most probable saviors.